Study: City areas with healthy eating, exercise options help control diabetes

By

Allen Cone

A woman walks in Times Square with a book on her head on September 21, 2016 in New York City. Researchers found that diabetics better controlled their disease in areas of New York with better health eating places and more physical activity options, including walking. Photo by John Angelillo/UPI | License Photo

April 6 (UPI) -- Diabetics better control their disease if they live in a city's area with options for healthier eating and physical activity, including walking, according to a study in New York.

Researchers at Columbia University's Mailman School of Public Health and the New York City Department of Health and Mental Hygiene found there are environmental factors involved in achieving glycemic control. The study was published in the April issue of the American Journal of Epidemiology.

They based their study on an analysis of multiple hemoglobin A1C measurements from 182,756 New York City adults with diabetes collected over a seven-year period until 2013.

"Our study is the first to look at a wide range of built and economic features of a residential environment and how they may affect a person's ability to control their diabetes," Dr. Andrew Rundle, an associate professor of Epidemiology at the Mailman School of Public Health, said in a press release. "And until now, no study had evaluated whether these cumulative exposures were associated with glycemic control in a large multiracial, multiethnic population."

The researchers said their findings are consistent with the premise that areas with greater resources for healthy eating and physical activity, and a high socioeconomic environment, are linked to improved glycemic control in people with diabetes.

Diabetes was defined as at least two A1C tests with a value equal to or greater than 6.5 percent. They found reductions in A1C levels through time -- below 7 percent.

Areas associated with better glycemic control, as seen in the top fifth of the study, were neighborhoods with greater ratio of healthy food outlets to unhealthy food outlets, and higher neighborhood walkability.

The least advantaged areas -- the lower one-fifth of the study -- had a larger number of residents, higher proportion of racial and ethnic minorities, and higher proportion of socioeconomic disadvantage

The researchers found that moving from less advantaged residential areas to better ones was related to improved diabetes control. And doing the opposite -- moving from more advantaged residential areas to less advantaged ones -- worsened diabetes control.

In 2006, the New York City Department of Health and Mental Hygiene began mandatory reporting of hemoglobin A1C tests to the A1C Registry.

"It is possible also, that the environments around where a person works may also affect their ability to achieve glycemic control," Rundle said. "However, since the A1C registry does not include information on work locations we were not able to test this idea with these data."

In a previous study spanning 14 cities and 10 countries involving 6,822 adults, researchers also found a well designed city -- including walking options -- helped reduce rates of obesity, diabetes and heart disease. This included the concentration of the number of urban elements of population, parks, public transit and intersections.

"Design of urban environments has the potential to contribute substantially to physical activity," researchers wrote in a 2016 study published in The Lancet. "[The] similarity of findings across cities suggests the promise of engaging urban planning, transportation and parks sectors in efforts to reduce the health burden of the global physical inactivity pandemic."